Paris (AFP)

Growing suspicion, infox propagated on social networks, poor health systems in poor countries: global vaccine coverage is stagnating and diseases such as measles are on the increase, which worries the health authorities.

- How is global vaccination evolving? -

It stagnates "dangerously", according to an annual report published in July by the World Health Organization (WHO) and the United Nations Children's Fund (Unicef).

In 2018, 19.4 million children under one year old did not receive the basic vaccines against diphtheria, tetanus and pertussis (DTP) or measles.

"This means that more than one in ten children do not get all the vaccines they need," said WHO official Kate O'Brien, presenting the report.

Nearly two-thirds of these unvaccinated children live in only ten countries: Angola, Brazil, Ethiopia, India, Indonesia, Nigeria, Pakistan, Philippines, Democratic Republic of Congo and Vietnam.

Overall, since 2010, the coverage rate for DTP and measles immunization has stagnated at 86%. Although "high", this rate is "insufficient", warns the WHO, according to which it would be necessary to reach 95% to protect themselves from epidemics.

For measles, this rate drops to 69% if you take into account the two doses of the vaccine, not just the first one.

WHO estimates that vaccination currently prevents 2 to 3 million deaths each year. However, according to her, "1.5 million additional deaths could be avoided if global vaccination coverage improved".

- What consequences? -

The most spectacular is the strong resurgence of measles in the world.

More than 360,000 cases have been reported since January, the "highest" since 2006, according to WHO.

Often benign, this highly contagious viral disease can lead to serious complications, respiratory (pulmonary infections) and neurological (encephalitis), especially in fragile people.

Before the arrival of vaccines in the 1970s, measles was a formidable killer of children (7 to 8 million estimated deaths per year in the world).

Between 2000 and 2016, the number of deaths due to measles fell sharply thanks to vaccination campaigns, from 550,000 to 90,000 according to WHO. But it has risen to 110,000 in 2017.

- Why is vaccination stagnating? -

The reasons are twofold: mistrust of vaccines mainly in rich countries, and problems of access to vaccines in poor countries, where health systems are failing.

France, the homeland of vaccination pioneer Louis Pasteur, is the most suspicious country: one in three French does not believe that vaccines are safe, according to a global survey published in late June by the Gallup polling institute for the United States. British medical NGO Wellcome.

After France, the most suspicious countries are Gabon, Togo, Russia and Switzerland. According to this survey, this mistrust of vaccines is widespread in rich countries, particularly in Europe.

Conversely, in Bangladesh or Rwanda, almost the entire population says they trust vaccines.

"In these countries, there are more contagious diseases, and their inhabitants probably see what happens when you are not vaccinated," said Imran Khan, who led the 'study.

- Why this distrust? -

Many "anti-vax" relies on a 1998 publication linking MMR (measles-mumps-rubella) and autism. However, it was established that its author, the British Andrew Wakefield, had falsified his results, and several studies have since shown that the vaccine does not increase the risk of autism.

But this theory continues to spread thanks to social networks.

Mistrust can also have religious motives.

In the United States, New York State, faced with a resurgence of measles in areas with a high Orthodox Jewish population, voted in June to remove the religious exemptions that parents could invoke to circumvent immunization obligations in the United States. schools.

Finally, in DR Congo, an audio recording circulated before the summer on social networks, calling to attack with machete all health care workers who come to vaccinate against Ebola, whose epidemic has already made more than 2,000 deaths.

According to WHO, mistrust of vaccines is one of the top ten threats to global health, alongside pollution, Ebola and the AIDS virus.

© 2019 AFP